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Long-term Care Choices Navigator Feedback

STOP, read this first!
If you were not able to find services to meet your needs, please send us your questions or comments or call 1-800-333-2433. Specialists are available to help you find services in your community.

Section One: Your Feedback

  1. Did you find the site easy to use?



    If not, can you tell us which steps you had trouble with and suggest what would make the site easier to use?
  2. Were you able to find what you were looking for in the site?


  3. The information I received from the Consumer Decision Tool helped me make a decision or find the service(s) I needed.



    If no, please explain
  4. Do you think the Recommendations from the health care professionals (bar graph) were helpful?



    If no, please explain
  5. Do you think the Recommendations helped you make a better decision about the type of care that is needed?



    If no, please explain
  6. May we contact you in 30 days to see if the services you found were helpful?



    Contact information:

    (If you select Yes, please leave your email or phone information so we can follow up with you.)
  7. Which term best describes the performance of this site?




    Please tell us what we could do to make the site easier to use

Section Two: Tell Us About Yourself

  1. Age:






  2. Gender:



  3. Optional - please answer if you are comfortable:
    Do you have a disability?


    If yes, what is your primary disability?





    Other?
  4. Optional - please answer if you are comfortable:
    What is your race/ethnicity?* (check all boxes that apply)
    White/non-Hispanic
    Native American
    Asian
    Hispanic/Latino
    African American
    Other
    *If you used the site on behalf of someone else, please answer these questions about that person.
  5. Are you looking for information for: (please check all that apply)
    Yourself
    Spouse/partner
    Parent
    Family member or friend
    Client
    Other

Section Three: Suggestions

  1. Do you have any other suggestions for changes to this site?
  2. Would you like us to contact you once we have resolved this issue?

  3. If yes, what is your contact information?